Job Application Form

Bourne
Water
District

WATER MAIN FLUSHING FAQ

Applicant Information

Last Name*

First Name*

Middle Initial*

Street Address*

Apartment/Unit #

City*

State*

Zip*

Phone*

Email*

Date Available*

Desired Salary*

Position Applied For*

Are you a citizen of the United States?*

Yes

If no, are you authorized to work in the US?

Yes

Have you ever worked for this company?*

Yes

If so, when?

Have you ever been convicted of a felony?*

Yes

If yes, explain.

Education

High School*

High School Address*

High School Start Date*

High School End Date*

Did you graduate High School?*

Yes

High School Degree

College

College Address

College Start Date

College End Date

Did you graduate College?

Yes

College Degree

Other Education

Other Education Address

Other Education Start Date

Other Education End Date

Did you graduate Other Education?

Yes

Other Education Degree

References

Reference 1 - Full Name*

Reference 1 - Relationship*

Reference 1 - Company

Reference 1 - Phone*

Reference 1 - Address*

Reference 2 - Full Name*

Reference 2 - Relationship*

Reference 2 - Company

Reference 2 - Phone*

Reference 2 - Address*

Reference 3 - Full Name*

Reference 3 - Relationship*

Reference 3 - Company

Reference 3 - Phone*

Reference 3 - Address*

Previous Employment

Employer 1 - Company

Employer 1 - Phone

Employer 1 - Address

Employer 1 - Supervisor

Employer 1 - Job Title

Employer 1 - Responsibilities

Employer 1 - Start Date

Employer 1 - End Date

Employer 1 - Reason for Leaving

Employer 1 - May we contact your previous supervisor for a reference?

Yes

Employer 2 - Company

Employer 2 - Phone

Employer 2 - Address

Employer 2 - Supervisor

Employer 2 - Job Title

Employer 2 - Responsibilities

Employer 2 - Start Date

Employer 2 - End Date

Employer 2 - Reason for Leaving

Employer 2 - May we contact your previous supervisor for a reference?

Yes

Employer 3 - Company

Employer 3 - Phone

Employer 3 - Address

Employer 3 - Supervisor

Employer 3 - Job Title

Employer 3 - Responsibilities

Employer 3 - Start Date

Employer 3 - End Date

Employer 3 - Reason for Leaving

Employer 3 - May we contact your previous supervisor for a reference?

Yes

Military Service

Branch

Enlistment Date

Discharge Date

Rank at Discharge

Type of Discharge

If other than honorable, explain.

I certify that my answers are true and complete to the best of my knowledge. I authorize investigation of all statements contained in this application as may be necesary in reaching an employment decision. I hereby understand and acknowledge that, unless otherwise defined by applicable law, any employment relationship with this organization is of an "at will" nature, which means that the employee may resign at any time and the employer may discharge the employee at any time with or without cause. IT is further understood that this "at will" employment relationship may not be changed by any written document or conduct unless such change is specifically acknowledged by the Board of Water Commissioners. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release. I understand also that I am required to abide by the Rules and Regulations of the District.

Signature (type your name to agree)

Signature Date

xfield

Website Design by Parker Digital Solutions

Job Application Form

Sitemap

Call Us

Location

By Mail

Sitemap

Call Us

Location

By Mail